I have a couple of questions regarding billing these procedure codes. I've received denials from Medicare when I bill the 82270 even though it states in the Medicare Preventive Services Billing Guide (dated Feb 2008) this is the code to use. It also says G0328 can used as an alternative to 82270. The denials are for 2009 dates of service and state this code is invalid on this date.

Does the diagnosis determine which code to bill? Should the G0328 be billed with a V code and the 82270 with a medical diagnosis? Also, my providers are giving me the 82270 to bill the same day as the office visit/PE. Can this be billed if one sample is taken/analyzed the same day as the appointment in the office and billed again when the cards are returned and analyzed? Does the patient's age make a difference as to which code to bill? Thanks in advance for any help/advice.